Methods and apparatus for vascular access

Abstract

Methods and systems are described for creating chronic vascular access or hemodialysis. These methods and systems eliminate the insertion of needles which are now required for using the available methods of obtaining vascular access. Thus multiple complications due to needle insertion through skin, tissue, and vein or graft wall are prevented. A low-profile stable transcutaneous implant's external surface and stability minimizes infection. The implant is readily joined to a connector device that functions substantially automatically and which provides high blood flow volumes for hemodialysis.

1 . A connector device for accessing an implant coupled to a graft forming part of a patient's vasculature, comprising:
 a. a housing including:
 i. an extraction assembly to remove a plug-in seal from an implant; 
 ii. a blood tube to access the vasculature; and 
 iii. an installation assembly including a new plug-in seal to insert the new plug-in seal into the implant; and 
   b. at least one locking tab to lock the housing onto the implant.   
   
   
       2 . The connector device of  claim 1 , wherein the graft is a PTFE graft. 
   
   
       3 . The connector device of  claim 1 , further comprising a cam dial, wherein rotation of the cam dial causes a distal movement followed by a proximal movement of at least one of the extraction assembly, blood tube, or installation assembly. 
   
   
       4 . The connector device of  claim 3 , wherein rotation of the cam dial causes a distal movement followed by a proximal movement of each of the extraction assembly, blood tube, and installation assembly. 
   
   
       5 . The connector device of  claim 4 , wherein rotation of the cam dial causes driving posts attached to respective one of the extraction assembly, blood tube, and installation assembly to move distally and proximally along a helical barrel cam track. 
   
   
       6 . The connector device of  claim 1 , wherein the installation assembly further comprising a locking pin, and wherein the locking pin is configured to be inserted within a plug-in seal to secure the plug-in seal against movement within the implant. 
   
   
       7 . The connector device of  claim 1 , further comprising a flush line to flush saline in a central passageway of the implant. 
   
   
       8 . The connector device of  claim 1 , wherein the extraction assembly, blood tube, and installation assembly are arranged within a turret, the turret rotating along with the cam dial. 
   
   
       9 . An implant for accessing the vasculature of a patient, comprising:
 a. a central cylinder;   b. a locking flange coupled to the central cylinder at a proximal end thereof;   c. an attachment mechanism coupled to a distal portion of the central cylinder, the attachment mechanism configured to attach the implant to a graft; and   d. an ingrowth disk surrounding at least a portion of the central cylinder.   
   
   
       10 . The implant of  claim 9 , wherein the implant is made of a material selected from the group consisting of: stainless steel, titanium, or combinations thereof. 
   
   
       11 . The implant of  claim 9 , wherein the locking flange further comprises a protruding lip and a locking channel. 
   
   
       12 . The implant of  claim 9 , further comprising a suture disk to secure the implant inside a patient. 
   
   
       13 . The implant of  claim 12 , wherein the suture disk is co-extensive with the ingrowth disk. 
   
   
       14 . An implant for accessing the vasculature of a patient, comprising:
 a. a central passageway;   b. a locking flange coupled to the central passageway at a proximal end thereof;   c. at least one horizontal passageway extending substantially perpendicularly to the central passageway, the horizontal passageway attached to the central passageway substantially at a distal end thereof; and   d. an ingrowth disk surrounding at least a portion of the central passageway.   
   
   
       15 . The implant of  claim 14 , wherein the implant is made of a material selected from the group consisting of: stainless steel, titanium, or combinations thereof. 
   
   
       16 . The implant of  claim 14 , wherein the locking flange further comprises a protruding lip and a locking channel. 
   
   
       17 . The implant of  claim 14 , further comprising another horizontal passageway extending substantially perpendicularly to the central passageway and in an opposite direction from the at least one horizontal passageway. 
   
   
       18 . The implant of  claim 14 , further comprising a suture disk to secure the implant inside a patient. 
   
   
       19 . The implant of  claim 18 , wherein the suture disk is co-extensive with the ingrowth disk. 
   
   
       20 . A method of accessing the vasculature of a patient, comprising:
 a. attaching a connector device to an implant;   b. locking the connector device onto the implant;   c. extracting a plug-in seal from the implant;   d. inserting a blood tube into the implant;   e. removing the blood tube from the implant;   f. installing a new plug-in seal into the implant; and   g. removing the connector device.   
   
   
       21 . The method of  claim 20 , further comprising priming the connector device. 
   
   
       22 . The method of  claim 20 , further comprising flushing the implant with saline. 
   
   
       23 . The method of  claim 20 , wherein the extracting a plug-in seal, inserting a blood tube, removing the blood tube, and installing a new plug-in seal, are accomplished by rotating a cam dial. 
   
   
       24 . A set of implants for accessing the vasculature of a patient, comprising:
 a first implant including:
 a central passageway; 
 a locking flange coupled to the central passageway at a proximal end thereof; 
 at least one horizontal passageway extending substantially perpendicularly to the central passageway, the horizontal passageway attached to the central passageway substantially at a distal end thereof, the horizontal passageway of the first implant accessing an artery of a patient; and 
 an ingrowth disk surrounding at least a portion of the central passageway; and 
 a second implant including:
 a central passageway; 
 a locking flange coupled to the central passageway at a proximal end thereof; 
 at least one horizontal passageway extending substantially perpendicularly to the central passageway, the horizontal passageway attached to the central passageway substantially at a distal end thereof, the horizontal passageway of the second implant accessing a vein of a patient; and 
 an ingrowth disk surrounding at least a portion of the central passageway; 
 such that blood may be removed from the patient using the first implant, treated by a dialyzer, and returned to the patient using the second implant. 
 
   
   
   
       25 . A method of accessing the vasculature of a patient, comprising:
 attaching a first connector device to a first implant;   locking the first connector device onto the first implant;   extracting a plug-in seal from the first implant;   inserting a blood tube into the first implant;   attaching a second connector device to a second implant;   locking the second connector device onto the second implant;   extracting a plug-in seal from the second implant;   inserting a blood tube into the second implant;   removing blood using the first blood tube, delivering the blood to a dialyzer, and delivering blood from the dialyzer to the patient using the second blood tube;   removing the blood tubes from the respective implants;   installing new plug-in seals into the respective implants; and   removing the connector devices.